Reticular Erythema Research Articles

Cutis Marmorata Telengiectatica Congenita with Kimura’s Disease and Nephrotic Syndrome as a Sequele to Membranoproliferative Glomerulonephritis

Cutis marmorata telangiectatica congenita (CMTC) is a rare capillary malformation characterized by persistent reticulated marbled erythema. A 16-year-old boy presented with reddish net-like lesion over the left side of his body which was initially noticed at the age of three, with slight fading over the years which did not disappear on local warming. On examination, he had nonblanchable, reticular erythema over the left side of the body, not crossing the midline. After complete evaluation, a diagnosis of CMTC was made. CMTC has been associated with musculoskeletal anomalies, vascular abnormalities, cardiac defects, neurological defects, and ocular anomalies. Once CMTC is diagnosed, it is crucial to identify and manage any associated anomalies through a multidisciplinary approach. Additionally, the patient was also diagnosed with Kimura’s disease and nephrotic syndrome secondary to membranoproliferative glomerulonephritis.

Parvovirus in dermatology: A review

AbstractParvovirus B19 is a small nonenveloped single‐stranded DNA virus belonging to the parvoviridae family. The dermatological manifestations are varied ranging from infective to inflammatory, but the most common among infective etiologies is erythema infectiosum, also known as the fifth disease or ‘slapped cheek’ disease, which is mildly contagious. Clinical corroboration of symptoms and signs with serum antibody levels has been seen in acute and persistent parvoviral infections. Other dermatological manifestations of parvovirus B19 infections include erythema multiforme, vasculitis, reticular erythema, maculopapular eruptions, pustular eruptions, papular‐purpuric gloves and socks syndrome (PPGSS) and Gianotti‐Crosti syndrome. Skin lesions are quite characteristic and begin with oedema and erythema symmetrically localized to the hands and feet. Subsequently, petechial and purpuric changes appear varying from a few millimetres in diameter to larger, confluent patches. The primary target of parvovirus B19 is the hematopoietic‐erythroid cell line, specifically near the pronormoblast stage and the vulnerability to cellular damage increases along the differentiation lineage. There's multimodal clinical phenotypic presentation seen in parvoviral infections. Among the clinical expression of HPV B19 infections, the most common is dermatologic, however other manifestations such as rheumatologic and hematologic are not uncommon. However, some infections can be asymptomatic, especially in immunocompetent hosts, whereas in others with haematological abnormalities, these can lead to aplastic cellular crises.

Cutis marmorata telangiectatica congenita

Cutis marmorata telangiectatica congenita (CMTC) is an uncommon, congenital, vascular malformation, characterised by a fixed, generalised or localised, reticulate erythematous rash. We report an eighty day old male child who presented with the above lesion involving the left upper and lower limbs with underlying atrophic changes.

Elastolysis mediodermalis - case report and review of literature

Elastolysis mediodermalis is a rare disorder typically observed in middle-aged women. Sites of predilection are the trunk and upper arms. The clinical picture varies and may appear as cigarette paper-like wrinkling, perifollicular protrusions or reticular erythema. In contrast to the different clinical morphology, there is a consistent histology, i. e. localized, band-shaped, and rarely focal loss of elastic fibers in the middle dermis. The etiology of elastolysis mediodermalis is unclear. UV radiation or immunological mechanisms may increase the release of matrix metalloproteinases, leading to a degradation of elastic fibers. There is no effective treatment for this condition.

Érythème cutané provoqué par une neurostimulation cordonale postérieure : deux observations

Cutaneous complications following implantation of an electric system have been reported mainly after the implantation of pacemakers, cardiac defibrillators and morphine pumps. However, cutaneous complications following implantation of spinal cord stimulators are rarely described in the literature. Here we report two cases of cutaneous eruption at the spinal cord stimulation site, one involving foreign-body reaction to silicone in the neurostimulator electrodes or connector block and the other comprising contact dermatitis to silicone.Case 1: A 43-year-old woman had been implanted with a spinal cord stimulator. Four months after implantation, burning sensation and cutaneous inflammatory erythema were observed in the dorsolumbar region, with reduced efficiency of stimulation. Removal of the neurostimulator led to resolution of the cutaneous symptoms. Histopathological examination of the biopsy sample showed foreign-body granuloma formation. The same symptoms subsequently recurred on the surgical scar and histopathology showed granuloma formation in response to particles of silicone present in the connector. The cutaneous eruption subsided rapidly after excision. Case 2: In a 60-year-old man implanted with a spinal cord stimulator, pruriginous reticular erythema was rapidly observed on the skin just above the neurostimulator, with papules around the erythema. Histopathology of two cutaneous biopsies showed evidence of contact dermatitis. Skin-patch tests performed with components of the neurostimulator leads proved positive to two types of silicone after 72 hours. The eruption was successfully controlled using topical corticosteroid therapy.Reports of cutaneous eruptions after spinal cord stimulation are extremely rare. Here we report two different cutaneous reactions with two different pathophysiological mechanisms, both involving silicone. The first case is original because it is the first documented case of a foreign-body reaction involving granuloma formation in response to particles of silicone present in the components of a neurostimulator. The second case concerns contact dermatitis to silicone (present in the connector block and electrode sheaths).

Mid-dermal elastolysis revisited

The clinical as well as histological data of 79 mid-dermal elastolysis (MDE) patients reported in the literature were evaluated. MDE is an acquired skin condition of the elastic tissue predominantly manifesting on the trunk and proximal extremities of young women. Most commonly observed skin changes include patches of well-circumscribed fine wrinkles (type I) and perifollicular papular protrusions (type II). Rarely, MDE may also occur with persistent reticular erythema and wrinkling (type III). The critical diagnostic histopathological feature of MDE is the selective loss of elastic fibres in the mid-dermis. Mild lymphohistiocytic infiltrates, elastophagocytosis of elastic fibres by macrophages, and even multinucleate giant cells are occasionally observed in MDE lesions. Immunohistological studies and cell culture experiments indicate that dysbalances in elastin turnover are associated with pathological degradative processes including increased elastolytic activity that finally lead to loss of elastic fibres in the mid-dermis. First-line differential diagnoses may include closely related conditions such as anetoderma, annular elastolytic giant cell granuloma, cutis laxa acquisita and pseudoxanthoma elasticum-like papillary dermal elastolysis. Future therapeutic approaches in MDE patients should focus on agents that are able to block increased elastase activity and induce elastin synthesis.

Reticular variant of mid-dermal elastolysis after insertion of a pacemaker

Summary Mid-dermal elastolysis is an unusual process characterized by the absence of the elastic fibres within the mid-dermis. The disappearance of these fibres causes fine wrinkles (type 1) or perifollicular protrusions (type 2) affecting the trunk, neck and arms. There is a female predilection, and most patients have a history of intense sun exposure. Recently, some cases of mid-dermal elastolysis presenting as reticular erythema have been reported. We report a case of reticular erythema with mid-dermal elastolysis that occurred in a 70-year-old man after insertion of a pacemaker.

Calcifilaxis

Calciphylaxis, also known as calcific uremic arteriolopathy, is a rare but serious vascular alteration with a high rate of morbidity and mortality. The prevalence ranges between 1 and 4% of patients with chronic renal failure. This disease most frequently affects the elderly, women, Caucasians, and persons with diabetes or HIV. The pathogenesis remains unclear, but various risk factors are involved, including secondary hyperparathyroidism, elevated calcium x phosphorus product >55 mg/dl, normal or high blood calcium levels, and high doses of active vitamin D metabolites, etc. Pathologically, this disease manifests as a small vessel vasculopathy in which there is mural calcification with intimal proliferation, fibrosis and eventually thrombosis of the affected vessel, resulting in ischemia of the irrigated tissue. Clinically, the disease manifests by subcutaneous nodules and extremely painful violet, purple or ecchymosis plaques, over a mottled or reticular erythema similar to livedo reticularis. In a few days these lesions progress to the formation of necrotic ulcers covered with black eschar. The diagnosis is suspected on the basis of history taking and physical examination. Therapeutic measures are ineffective and should be directed at controlling phosphorus and calcium and standardizing calcium x phosphorus product is< 55mg/dl. The use of active vitamin D metabolites should be avoided.

Reticular erythema with focal mid‐dermal elastophagocytosis (REMDE)

A 57-year-old man presented with a persistent arcuate partly reticular erythema of the upper chest. Histopathological examination revealed an upper and mid-dermal perivascular and interstitial dermatitis with macrophages which had engulfed elastic fibers. Additionally a focal dermal elastolysis was observed. The characteristic clinicopathological constellation has hitherto been reported in only 3 cases, including our case. Presumably, the disease belongs to a spectrum of clinical manifestation of mid-dermal elastolysis. It is suggested to gather future cases under the provisional diagnosis ''reticular erythema with focal mid-dermal elastophagocytosis" (REMDE) to gain more insights into this rare disease.

A case of reticular erythematous mucinosis

报告1例网状红斑性黏蛋白沉积症.患者以胸背部的持久性光加重性网状红斑为主要表现,伴有点片状表面萎缩的白斑和坏死结痂,不伴系统损害,常规实验室检查无异常发现.组织病理显示,真皮有单核细胞浸润和阿辛蓝染色阳性的黏蛋白沉积.根据患者皮损的临床病理特征、组织病理及阿辛蓝染色等,诊断符合网状红斑性黏蛋白沉积症,本病临床少见。

Cutaneous reactive angiomatosis occurring in erythema ab igne can cause atypia in endothelial cells: Potential mimic of malignant vascular neoplasm

Erythema ab igne (EAI), an old and rare disease, is an erythematous, often pigmented, reticular, macular dermatosis that occurs at the site of repeated exposure to moderate heat. Reported herein is an unusual case of EAI occurring in a 33-year-old woman with a very broad lesion of reticular erythema and pigmentation on the lower extremities. The patient frequently put her lower extremities close to a heater in the wintertime to alleviate chill. The lesion started a decade ago, and it gradually became conspicuous. Microscopic findings showed a proliferation of small blood vessels in a thickened papillary dermis, not as typical as seen in EAI, but as seen in cutaneous reactive angiomatosis. They were arranged as small lobules and associated with hyalinization, edema and delicate fibroplasia. Many vessels were lined by plump endothelial cells, some of which had enlarged hyperchromatic nuclei. Many of these cells were multinucleated. Similar-appearing cells were associated with concentric foci of hyalinization without vascular lumina. A few atypical mitoses were observed. The lesion became much less conspicuous after the patient started avoiding close exposure to a heater, without any other special treatments. The aforementioned changes may be confused with malignant vascular neoplasm because of unusual cytological atypia and atypical mitoses in the endothelial cells.

Érythème annulaire réticulé annonciateur de crises d’œdème angioneurotique héréditaire chez un enfant

Hereditary angioedema is characterized by episodes of subcutaneous, digestive or laryngeal edema. In some cases, non-pruritic reticular erythema may precede the episodes of edema. Every 4 to 6 weeks since infancy, a girl presented non-pruritic widespread reticular erythema, sparing the face. Two or three times every year, abdominal pain or edema of the lower limb joints followed the skin eruption. At 12 years of age, she was hospitalized because of an edema of the face associated with the eruption. Exploration of the complement confirmed the diagnosis of type I hereditary angioedema. The mean delay before diagnosis of hereditary angioedema is of 7 years. Reticular erythema in hereditary angioedema is frequent (40p. 100 of cases) and it usually occurs early in childhood, even in the absence of any episode of angioedema. When present, these eruptions usually precede an episode of angioedema. Recognition of this eruption as a symptom of hereditary angioedema would shorten the delay before diagnosis and anticipate appropriate management of the episodes.

Telangiectatic Reticular Erythema Unrelated to Cardiac Devices

Telangiectatic Reticular Erythema Unrelated to Cardiac Devices

Reticular Erythema of the Lower Back

REPORT OF A CASE A 38-year-old white man was involved in an automobile accident in 1967 with resulting damage to the T-10 vertebrae and chronic pain. Two years ago, the patient bought a chair with an electric vibrator and a heater cushion to ease his lower back pain. He started using it every night for a few hours while watching television. One month after starting the device, an eruption developed on his lower back. The eruption was sometimes accompanied by crusted areas on the location where the heater and vibrator touched his skin. Figure 1 shows the diffuse, blue-to-purple erythematous reticulated eruption, with hyperpigmentation of the lower back without vesicles or hyperkeratosis. A 3-mm punch biopsy specimen was obtained from this area. Histologic findings are demonstrated in Fig 2. What is your diagnosis? DIAGNOSIS: Erythema ab igne. DISCUSSION Erythema ab igne, otherwise known as toasted skin syndrome, 1,2 is a persistent macular erythema and hyperpigmentation occurring in a

Reticular erythema with ostial porokeratosis

An asymptomatic reticular erythema associated with myriads of monomorphous micropap-ules developed in a symmetric distribution concentrated on the inner aspects of both arms and both legs of a 15-year-old girl. Skin biopsy specimens revealed cornoid lamellae within multiple appendageal ostia and focal lymphocytic inflammation in the papillary dermis. Reticular erythema with ostial porokeratosis is one of an increasing number of clinical presentations of punctate porokeratosis that lack a classic marginated rim.

REM syndrome: reticular erythematous mucinosis (round-cell erythematosis), a new entity?

SUMMARY Four patients, three females and one male, were observed in Cologne with sheet- or net-like erythema of the upper chest and of the back, with a tendency to spread to the abdomen. The patients had no symptoms with the exception of itching in one case and itching after sunburn in another. Histo-logically the epidermis was normal, apart from slight hydropic degeneration and some minor degree of spongiosis. The main features were: dilated blood vessels in the dermis, with a more or less pronounced perivascular infiltrate of round cells, and, in addition, deposits of a substance which stained with alcian blue. Oral treatment with Rhetis was of some benefit, otherwise therapy, including corticosteroids, was not successful. Other antimalarial drugs were not used. There was some relation to sun exposure, but the full spectrum of xenon-light did not cause any abnormal reactions. Since it was not possible to relate these findings to any known syndrome, a combination of the main signs, reticular erythema and mucinosis, was used to name this entity REM syndrome.